Helpers Who Hurt

Novels that feature therapists and the therapeutic process have the power to influence public opinion in subtle ways.

I have previously noted that arguing that all fictional therapists should be neat and ideal is unrealistic and, frankly, unappealing. However, when books, even fictional ones, depict ethical breaches and unconventional interventions as routine, they do harm to a reader population for whom these negative expectations might interfere with help-seeking. The same is true of books that globally dismiss therapy as ineffective.

In The Good Samaritan (2017) by John Marrs, Laura is a suicide helpline volunteer who has dark secrets and a darker agenda: she finds “candidates” who she coaches through the suicide process, even when those individuals begin to have second thoughts and want to live. She is portrayed as a sociopath and she delights in causing harm away from the hotline as well. She chillingly notes:

“For the more vulnerable out there, once the darkness falls, so do their barriers. Nighttime is their enemy, because with fewer visible distractions there’s more opportunity to dwell on how hopeless their lives have become. It’s when they reach out for somebody’s hand.”

She savors this vulnerability and preys on it. Laura is clearly a fictional character; it is difficult to imagine a reader losing faith in helplines because of this depiction. The same novel does have some potentially problematic portrayals of therapy as a whole, though.

When young Charlotte begins suffering devastating depression during her pregnancy, her husband Ryan encourages her to seek professional intervention. She derives no benefit and is indifferent to the entire endeavor:

“After much persuasion, she began cognitive behavioural therapy. Three sessions later she dismissed her therapist as a ‘dick’ and never returned.”

Of course, there is no requirement that fictional authors portray psychotherapy in a positive light. But it is worth discussion in terms of potential attitudinal barriers to care, particularly when therapy is consistently negatively portrayed in a particular work.

After Charlotte’s story reaches a tragic conclusion, Ryan is consumed by grief. He receives a pamphlet about adaptive coping strategies and has a visceral rejection reaction, even wondering if the provider is suggesting that he get a hamster to replace his dead wife (one of the suggested coping strategies was the acquisition of a pet).

Turning his back on both professional and personal help (family and friends consistently reach out to him), Ryan instead begins seeking revenge on Laura. In his attempts to butter her up and pave the way for his scheme, he states:

“You aren’t like those therapists and counselors who try to tell me how much I have to live for, or dose me up on a cocktail of drugs so I can’t think straight anymore. You properly care.”

While he makes this statement as part of a manipulation, it is consistent with the portrayals of therapy and therapists throughout the book. These sorts of portrayals have a place in books, fiction or otherwise. But there should also be a place for arguments to the contrary.

Helpers Who Hurt

Kathryn Lawson

Kathryn Lawson, PhD is a clinical psychologist in Peachtree City, Georgia, specializing in the treatment of trauma/PTSD, grief, anxiety and depression among older adolescents and adults. Before transitioning to private practice, she worked for the Bureau of Prisons for 10 years. During that time, she also worked as an adjunct faculty member at a small college, teaching diverse groups of nontraditional students. Her private practice, teaching, and government service have all been guided by a commitment to reaching underserved populations. Dr. Lawson is passionate about issues of stigma and inclusion and how these impact individuals affected by mental illness.